In response to a significant ongoing disruption to the supply of Clarithromycin 125mg/5ml and 250mg/5ml oral suspension, two new Serious Shortage Protocols (SSPs) have been issued by the Department of Health and Social Care (DHSC).

Effective 6 April 2023, SSP053 and SSP054 provides for the following:

SSP053 – for every 5ml of Clarithromycin 125mg/5ml oral suspension, 2.5ml of Clarithromycin 250mg/5ml oral suspension must be supplied.
SSP054 – for every 5ml of Clarithromycin 250mg/5ml oral suspension, one Clarithromycin 250mg tablet must be supplied.

Both SSPs are currently set to expire on 28 April 2023.

The SSPs may be amended or revoked at any time – PSNC will update contractors on any changes.

SSP053 for Clarithromycin 125mg/5ml oral suspension

For prescriptions (NHS or private) requesting:
Supply permitted under SSP053:
Clarithromycin 125mg/5ml oral suspension
Clarithromycin 250mg/5ml oral suspension

SSP054 for Clarithromycin 250mg/5ml oral suspension

For prescriptions (NHS or private) requesting:
Supply permitted under SSP054:
Clarithromycin 250mg/5ml oral suspension
Clarithromycin 250mg tablet

Both SSPs, authorised by the Secretary of State, have been developed by clinicians and provides pharmacists with procedures to follow in providing either of these suitable alternative products to help reduce the number of patients having to return to their prescriber for a replacement prescription.

Key points relating to SSP053 and SSP054

These protocols do not allow for the quantity supplied to be less than the number of days prescribed on original prescription.
SSP053 does not allow the substitution of oral suspension for tablets
Ensure that patients considered unsuitable for inclusion are promptly referred to their prescriber for further advice.
The supervising pharmacist should ensure that the patient’s prescriber is notified when supplying a patient in accordance with these SSPs
For endorsing requirements please refer to NHSBSA’s supporting guidance for SSP053 and SSP054 respectively.

Pharmacists must exercise their professional judgement to ensure the alternative products are suitable for the patient.

Contractors will receive an email to their shared NHSmail account informing them of these SSPs and pharmacy teams are advised to read the documentation for SSP053 and SSP054 in full and to implement the protocol with immediate effect. Pharmacists are required to read and comply with the requirements outlined within the individual SSP as published on the NHSBSA website for SSP053: Clarithromycin 125mg/5ml oral suspension and SSP054: Clarithromycin 250mg/5ml oral suspension.


Reimbursement is for the medicine supplied in accordance with the SSP and not the originally prescribed medicine i.e. in this instance contractors will be reimbursed the reimbursement price for either Clarithromycin 250mg/5ml oral suspension or Clarithromycin 250mg tablet. The reimbursement price will account for VAT payment. Supply in accordance with the SSP will result in the following fees being paid to the contractor:

One Single Activity fee (currently £1.27)
One SSP fee (£5.35)

Support in implementing the SSPs

The following resources have been developed to support pharmacy teams in using these protocols.

Current versions of SSPs

Serious Shortage Protocols Operational Guidance

Serious Shortage Protocols Questions & Answers

PSNC’s Serious Shortage Protocols (SSPs) Endorsing Factsheet

PSNC Briefing 023/19: Serious Shortage Protocols – A guide for community pharmacy teams

Background information on SSPs

Further information on what SSPs are and when they may be used is available via the links below.

Serious Shortage Protocols (SSPs) on-demand webinar

Serious Shortage Protocols (SSPs) webpage

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